How Gut Bacteria Could One Day Help Stop Diabetes Before It Starts

We still don't completely understand all the factors that cause someone to develop type 1 diabetes, but emerging research on gut bacteria reveals that the microorganisms may play an important role in keeping energy levels up and metabolic problems down -- major issues when it comes to diabetes care.

To examine the role of gut bacteria in type 1 diabetes further, researchers Marcus de Goffau, Ph.D., and Hermie Harmsen, Ph.D., of University Medical Center Groningen in the Netherlands took stool samples from very young children who had just been diagnosed with type 1 diabetes (ages ranged from 1-5) and compared them to samples from children without diabetes.

They found that even though both sets of children still had a long way to go in growing a diverse and balanced gut bacteria ecosystem, there were already stark differences in bacteria levels between kids who had type 1 diabetes and kids who did not. The study, published recently in the journal Diabetologia, is noteworthy because not much is known about the gut bacteria of such young type 1 diabetes patients.

"The incidence in type 1 diabetes is especially strong and rising in the youngest age cohort -- around 1 to 5 years old," said de Goffau in an interview with HuffPost. "Another reason we wanted to look at children of such a young age is that we wanted to look at the rapid development of the gut microbiota in very young children with type 1 diabetes."

De Goffau's team collected samples from 28 European children with type 1 diabetes (the children hailed from France, Greece, Estonia, Lithuania and Finland) and matched them up by age to 27 children without diabetes (all except one were from Finland).

Researchers found lower levels of helpful bacteria like Clostridium clusters IV and XIVa in diabetic kids under three years old as compared to their age-matched healthy control group. Clostridium clusters IV and XIVa are important because they contain most of the bacteria species that produce butyrate, an acid that helps prevent and minimize inflammation, as well as prevents metabolic disorder. Butyrate is also readily absorbed by the gut and turned into energy for the body.

In kids over three years old, researchers found that the healthy controls' Clostridium clusters IV and XIVa had bacteria that produced even more butyrate than the age-matched diabetic kids.

"If you do not have enough of these butyrate-producing bacteria species, you will become more likely to develop type 1 diabetes," said de Goffau.

The diabetic kids over three years old also had "unusually high microbial diversity," similar to the unstable bacterial networks like the ones found in children with celiac disease or adults with colorectal cancer.

"In all gut microbiota, it's always about balance," explained de Goffau. "You don't simply have one bacterial group which is 'good.' You should always have a number of good bacteria groups working together."

De Goffau also offered up this advice for people with type 1 diabetes: lean harder on fruits and vegetables, and perhaps less so on starches, excessive protein and animal fat. The good bacteria that produces helpful butyrate feast on fruits and vegetables, but eating too much of the other food groups gives unhelpful bacteria a chance to thrive and overtake butyrate-producing microorganisms.

De Goffau forsees a future in which health care workers can easily and routinely monitor gut bacteria to stop a problem before it starts.

"If you see wrong bacterial patterns developing in children, you might think, ok this is the time to try to do something," said De Goffau. "In this sense, we might in fact prevent some cases of diabetes in the future."

Other researchers, like Julian Marchesi, Ph.D., of the Centre for Digestive and Gut Health at Imperial College London, have also been studying a bacterial cure for type 1 diabetes. Last April, Marchesi published a study on how transferring the gut bacteria from a specially bred diabetes-resistant mouse into normal mice successfully changed the normal mice's microbiome. The gut bacteria transfer also significantly delayed the onset of diabetes in normal mice.

Marchesi wasn't involved in de Goffau's study, but reviewed its results and praised it for possibly identifying butyrate levels as a way to predict someone's risk for developing type 1 diabetes. He also said the research provided even more support for the importance of diet in controlling type 1 diabetes, since the type of bacteria that produces butyrate thrives on fruits and vegetables.

Marchesi also called for more research with larger, controlled groups of children and urged caution when interpreting the current study's results.

"The main issue we have at the present moment is that these types of studies highlight associations and do not identify causal agents," wrote Marchesi in an email to HuffPost. "Furthermore, we must also be careful when interpreting data generated from faecal samples, since this only represents a small part of the large intestines."

Type 1 diabetes is an autoimmune disease in which the body mistakenly attacks insulin-producing cells, eventually destroying the pancreas' ability to make insulin and regulate blood sugar. It is usually diagnosed in children and young adults, although people of any age can get it.

For reasons that are still unclear, Finland has the highest rates of type 1 diabetes in the world. Every year, 58 out of 100,000 children are diagnosed with the disease in Finland, while only 24 out of 100,000 children are diagnosed in the U.S. Currently, de Goffau is working on research that compares the gut bacteria of Finnish children to the microbiota of children from around the world.